Jan. 19, 2010 -- Parents may not be as concerned as they should be when
their children are diagnosed with concussions, but the term "mild
traumatic brain injury" may be more accurate and should be used more often, new
research suggests.

In a report in the February issue of Pediatrics, published online on
Jan. 18, researchers say some doctors and parents may not be as concerned as
they should be by a diagnosis of concussion, which could lead to serious
problems.

Concussion vs. Brain Injury

The research, by scientists at McMaster University, say doctors consider
traumatic brain injury and concussion as two separate diagnostic categories,
when in truth, both reflect brain injury.

The diagnosis of concussion is strongly associated with earlier discharge
from the hospital and earlier return to school activities, the researchers
say.

But in light of a current re-examination of brain injuries and return to
activities, including sports such as hockey and football, the researchers
recommend that more specific descriptions of concussion and brain injury should
be used.

"Even children with quite serious injuries can be labeled as having a
concussion," study researcher Carol A. DeMatteo, MSC, says in a news
release. "Concussion seems to be less alarming than 'mild brain injury,' so it
may be used to convey an injury that should have a good outcome, does not have
structural brain damage and symptoms that
will pass."

But that's not necessarily true, because a concussion could have serious
consequences, the researchers report.

Diagnosing Concussions

The researchers analyzed the medical records of 434 children admitted over a
two-year period to McMaster Children's Hospital in Hamilton, Canada with
the diagnosis of acquired brain injury. Of the 341 with traumatic brain injury,
32% had received a diagnosis of concussion, the researchers say.

Despite the severity of the injury, children said to have a concussion
stayed fewer days in the hospital and the term was a strong predictor of
earlier discharge. And they were more than twice as likely to go back to school
sooner following hospital discharge.

"Our study suggests that if a child is given a diagnosis of a concussion,
the family is less likely to consider it an actual injury to the brain,"
DeMatteo says in the news release. "These children may be sent back to school
or allowed to return to activity sooner, and maybe before they should. This
puts them at greater risk for a second injury, poor school performance, and
wondering what is wrong with them."

Using the term "mild traumatic brain injury" rather than "concussion" might
help people better understand what they are dealing with and improve decisions
about what the children should be allowed to do, DeMatteo and her colleagues
contend.

How Is Concussion Defined?

There are no universally accepted guidelines for using a diagnosis of
concussion in children, so more specific descriptors ought to be used, for both
clinical and research purposes, the researchers say.

Clinicians might use the concussion diagnosis because it alarms parents less
than "mild brain injury," implying the injury will soon pass and that is has no
long-term health consequences, the researchers write.

"There are currently at least eight difference scales for concussion, with
no universal agreement on the definition or grades of concussion," the
researchers write. "But there is a lack of scientific evidence to support any
of the concussion-grading systems."

This is true even though a diagnosis of concussion could range from mild,
with prolonged loss of consciousness, to severe, with no return to
consciousness and potentially death, the researchers write.